Editor's Note: The following is part 1 of an online series for National Sandwich Generation Month, aimed at bringing support and awareness to those families sandwiched between raising their kids and caring for aging parents.
Have you ever felt “sandwiched” between the pressures of caring for an older parent and raising your own family? If so, you are part of a unique group of people known as the “Sandwich Generation.” These are adults who are juggling the roles of caring for their own families (including minor children) and aging parents at the same time.
July is National Sandwich Generation Month - a month to encourage you to have the tough but necessary talk with your parents about their wishes for healthcare and long-term care.
Let's be honest, no one likes to think about a time when they may be too sick or too old to care for themselves. But, it's a fact of life that needs to be dealt with. Illness, injuries, disability and even death can strike without warning. If you don't talk about these potential medical issues NOW with your parents while they are sill in good health and of sound mind, there's a good chance you'll find yourself unprepared if a healthcare crisis occurs.
Even if you think you have an idea of the type of care your parents would want as they age or when they are no longer able to care for themselves, do yourself a favor and ASK anyway. You may be shocked to learn at this point in her life, mom no longer wants to be resuscitated if something happens to her. Or, maybe dad wants the family to do everything possible to keep him at home in his senior years instead of going to a facility. These are preferences that your parents are unlikely to bring up to you, but you'll be empowered to honor their wishes if you simply ask.
Another thing to keep in mind is that a lack of clarity surrounding an older parent's wishes for health or long-term care can tear even the closest family apart during a crisis.
Our office frequently gets calls from distraught adult children, asking us to help them because one sibling or family member is making decisions that they believe their mom or dad would have NEVER wanted. Sometimes the fight is over life support; one sibling wants to keep mom or dad on a ventilator or feeding tubes while the other siblings feel the parent would have wanted them to “pull the plug.” When no reasonable compromise is possible, these issues end up with lawyers and the courts involved.
If only there was a healthcare directive or living will that mom or dad had created in advance, much of this fighting (not to mention the time and expense of lawyers and court fees) could have been avoided. The children would have instead been empowered with a solid roadmap that lays out what the parent wants—not the children. This removes much of pressure to fight over decisions during an already emotionally-charged time.
That's not the only reason to create a healthcare directive, however. This document is also important to give the parent a say in whom they want to make life or death decisions for them in an emergency.
Someone has to be in control if the parent can not speak for themselves. If the parent does not have a proper healthcare directive in place, a local court will be the one to decide who this person is. And, it may shock you to know that the person they appoint does not have to be a family member! It could be a total stranger that gets the right to call the shots over your parent's healthcare. I'm pretty sure you would never want that, nor would your parents. So take the time to choose a healthcare agent (the person who can legally make decisions) and document mom or dad's wishes while they are still of sound mind and legally able to sign their own documents.
Still feeling uncomfortable about having this talk? The following conversation starters can help you get the ball rolling:
Sit down with your parents in a relaxing and non-threatening environment as you gently and thoughtfully discuss the following topics. Remind your parents that there are no right or wrong answers and no pressure to answer a certain way because they “think” that's what the family wants. Ask them simply for their honestly as you explore:
· What kind of lifesaving procedures would you want performed if necessary? Some examples to provide them may be resuscitation and defibrillation.
· Are there any lifesaving procedures you would NOT want performed? Feeding tubes and ventilators would be some examples.
· Who do you want to make medical or financial decisions for you if you become incapacitated?
· If feasible, would you rather live in an assisted living facility or have in-home assistance?
· If it's necessary for you to go to a nursing home, how would you want to pay for it?
· Do you have an up-to-date estate plan? If so, where can we find the documents and what is the name of your attorney?
By starting out with these basic questions, you may find that your parents' wishes differ from what you believed them to be, but you will also find that your duties as a caregiver are much clearer now that you have the information necessary to make difficult decisions and plan ahead.